Review

. 2025 Jul 17;26(1):164.

doi: 10.1186/s10194-025-02098-w.

Hallmarks of primary headache: part 2- Tension-type headache

Li-Ling Hope Pan^#¹, Yu-Hsiang Ling^#^{2

3

4}, Shuu-Jiun Wang^#^{5

6

7

8}, Linda Al-Hassany⁹, Wei-Ta Chen^{2

4

10}, Chia-Chun Chiang¹¹, Soo-Jin Cho¹², Min Kyung Chu¹³, Gianluca Coppola¹⁴, Adriana Della Pietra¹⁵, Zhao Dong¹⁶, Esme Ekizoglu¹⁷, Charl Els^{18

19}, Fatemeh Farham²⁰, David Garcia-Azorin^{21

22}, Woo-Seok Ha¹³, Fu-Jung Hsiao¹, Ryotaro Ishii²³, Byung-Kun Kim²⁴, Najib Kissani²⁵, Alejandro Labastida-Ramirez^{26

27}, Kristin Sophie Lange^{28

29}, Ellina Lytvyak¹⁸, Dilara Onan³⁰, Aynur Ozge^{31

32}, Laura Papetti³³, Lanfranco Pellesi³⁴, Bianca Raffaelli^{28

29}, Alberto Raggi³⁵, Sebastian Straube^{18

36}, Tsubasa Takizawa³⁷, Surat Tanprawate³⁸, Derya Uğurlu Uludüz³⁹, Kiratikorn Vongvaivanich⁴⁰, Marta Waliszewska-Prosół⁴¹, Yonggang Wang⁴², Tissa Wijeratne^{43

44}, Jr-Wei Wu^{2

4}, Sophie Merve Yener^{45

46}, Paolo Martelletti^#⁴⁷

Affiliations

¹ Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
² Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
³ Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁴ School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁵ Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. sjwang@vghtpe.gov.tw.
⁶ Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. sjwang@vghtpe.gov.tw.
⁷ School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. sjwang@vghtpe.gov.tw.
⁸ Department of Neurology, Neurological Institute, Taipei Veteran General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Beitou Dist, Taipei, 11217, Taiwan. sjwang@vghtpe.gov.tw.
⁹ Department of Internal Medicine, Division of Vascular Medicine and Pharmacology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
¹⁰ Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan.
¹¹ Department of Neurology, Mayo Clinic, Rochester, MN, USA.
¹² Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea.
¹³ Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
¹⁴ Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino ICOT, Latina, Italy.
¹⁵ Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
¹⁶ Department of Neurology, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
¹⁷ Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
¹⁸ Department of Medicine, Division of Preventive Medicine, Faculty of Medicine and Dentistry, University of Alberta, University of Alberta, Edmonton, AB, Canada.
¹⁹ Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
²⁰ Headache department, Iranian center of Neurological researchs, Neuroscience Institute, Tehran university of Medical Sciences, Tehran, Iran.
²¹ Department of Neurology, Hospital Universitario Rio Hortega, Valladolid, Spain.
²² Department of Medicine, dermatology and toxicology, University of Valladolid, Valladolid, Spain.
²³ Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
²⁴ Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, South Korea.
²⁵ Neurology Department, Mohammed VI University Hospital Center of Marrakech, Marrakech, MAR, Morocco.
²⁶ Division of Neuroscience, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, UK.
²⁷ Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance NHS Foundation Trust, University of Manchester, Manchester, UK.
²⁸ Department of Neurology, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
²⁹ Clinician Scientist Program, Berlin Institute of Health, Berlin, Germany.
³⁰ Department of Physiotherapy and Rehabilitation, Faculty of Heath Sciences, Yozgat Bozok University, Yozgat, Turkey.
³¹ Professor of Neurology, Headache Clinic, Mersin, Turkey.
³² NOROM Neuroscience and Excellence Center, Ankara, Turkey.
³³ Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
³⁴ Department of Public Health, Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark.
³⁵ Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
³⁶ School of Public Health, University of Alberta, Edmonton, AB, Canada.
³⁷ Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
³⁸ Chiang Mai University, Chiang Mai, Thailand.
³⁹ Department of Neurology, Istanbul Cerrahpasa University Medical Faculty, Istanbul, Turkey.
⁴⁰ Neuroscience center, Bangkok International Hospital, BDMS, Bangkok, Thailand.
⁴¹ Neurology, Wroclaw Medical University, Wroclaw, Poland.
⁴² Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁴³ Department of Neurology, Sunshine Hospital, Western Health, VIC, St Albans, Australia.
⁴⁴ Professor of Neurology, Faculty of Medicine, University of Rajarata, Saliyapura, Anuradhapura, Sri Lanka.
⁴⁵ Migraine Foundation Australia, Melbourne, VIC, Australia.
⁴⁶ Department of Neurology, Monash Health, Melbourne, VIC, Australia.
⁴⁷ School of Health, Unitelma Sapienza University of Rome, Rome, Italy.

^# Contributed equally.

PMID: 40676501
PMCID: PMC12273213
DOI: 10.1186/s10194-025-02098-w

Review

Hallmarks of primary headache: part 2- Tension-type headache

Li-Ling Hope Pan et al. J Headache Pain. 2025.

. 2025 Jul 17;26(1):164.

doi: 10.1186/s10194-025-02098-w.

Authors

Affiliations

¹ Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan.
² Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan.
³ Institute of Clinical Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁴ School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
⁵ Brain Research Center, National Yang Ming Chiao Tung University, Taipei, Taiwan. sjwang@vghtpe.gov.tw.
⁶ Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan. sjwang@vghtpe.gov.tw.
⁷ School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan. sjwang@vghtpe.gov.tw.
⁸ Department of Neurology, Neurological Institute, Taipei Veteran General Hospital, No. 201, Sec. 2, Shi-Pai Rd., Beitou Dist, Taipei, 11217, Taiwan. sjwang@vghtpe.gov.tw.
⁹ Department of Internal Medicine, Division of Vascular Medicine and Pharmacology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands.
¹⁰ Department of Neurology, Keelung Hospital, Ministry of Health and Welfare, Keelung, Taiwan.
¹¹ Department of Neurology, Mayo Clinic, Rochester, MN, USA.
¹² Department of Neurology, Dongtan Sacred Heart Hospital, Hallym University College of Medicine, Hwaseong, Republic of Korea.
¹³ Department of Neurology, Yonsei University College of Medicine, Seoul, Republic of Korea.
¹⁴ Department of Medico-Surgical Sciences and Biotechnologies, Sapienza University of Rome Polo Pontino ICOT, Latina, Italy.
¹⁵ Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, IA, USA.
¹⁶ Department of Neurology, The First Medical Center of Chinese PLA General Hospital, Beijing, China.
¹⁷ Department of Neurology, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey.
¹⁸ Department of Medicine, Division of Preventive Medicine, Faculty of Medicine and Dentistry, University of Alberta, University of Alberta, Edmonton, AB, Canada.
¹⁹ Department of Psychiatry, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
²⁰ Headache department, Iranian center of Neurological researchs, Neuroscience Institute, Tehran university of Medical Sciences, Tehran, Iran.
²¹ Department of Neurology, Hospital Universitario Rio Hortega, Valladolid, Spain.
²² Department of Medicine, dermatology and toxicology, University of Valladolid, Valladolid, Spain.
²³ Department of Neurology, Kyoto Prefectural University of Medicine, Kyoto, Japan.
²⁴ Department of Neurology, Nowon Eulji Medical Center, Eulji University School of Medicine, Seoul, South Korea.
²⁵ Neurology Department, Mohammed VI University Hospital Center of Marrakech, Marrakech, MAR, Morocco.
²⁶ Division of Neuroscience, Faculty of Biology, Medicine, and Health, University of Manchester, Manchester, UK.
²⁷ Geoffrey Jefferson Brain Research Centre, Manchester Academic Health Science Centre, Northern Care Alliance NHS Foundation Trust, University of Manchester, Manchester, UK.
²⁸ Department of Neurology, Charité- Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany.
²⁹ Clinician Scientist Program, Berlin Institute of Health, Berlin, Germany.
³⁰ Department of Physiotherapy and Rehabilitation, Faculty of Heath Sciences, Yozgat Bozok University, Yozgat, Turkey.
³¹ Professor of Neurology, Headache Clinic, Mersin, Turkey.
³² NOROM Neuroscience and Excellence Center, Ankara, Turkey.
³³ Developmental Neurology Unit, Bambino Gesù Children's Hospital, IRCCS, Rome, Italy.
³⁴ Department of Public Health, Clinical Pharmacology, Pharmacy and Environmental Medicine, University of Southern Denmark, Odense, Denmark.
³⁵ Neurology, Public Health and Disability Unit, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy.
³⁶ School of Public Health, University of Alberta, Edmonton, AB, Canada.
³⁷ Department of Neurology, Keio University School of Medicine, Tokyo, Japan.
³⁸ Chiang Mai University, Chiang Mai, Thailand.
³⁹ Department of Neurology, Istanbul Cerrahpasa University Medical Faculty, Istanbul, Turkey.
⁴⁰ Neuroscience center, Bangkok International Hospital, BDMS, Bangkok, Thailand.
⁴¹ Neurology, Wroclaw Medical University, Wroclaw, Poland.
⁴² Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
⁴³ Department of Neurology, Sunshine Hospital, Western Health, VIC, St Albans, Australia.
⁴⁴ Professor of Neurology, Faculty of Medicine, University of Rajarata, Saliyapura, Anuradhapura, Sri Lanka.
⁴⁵ Migraine Foundation Australia, Melbourne, VIC, Australia.
⁴⁶ Department of Neurology, Monash Health, Melbourne, VIC, Australia.
⁴⁷ School of Health, Unitelma Sapienza University of Rome, Rome, Italy.

^# Contributed equally.

PMID: 40676501
PMCID: PMC12273213
DOI: 10.1186/s10194-025-02098-w

Abstract

Background and aim: Tension-type headache is the most prevalent primary headache disorder. While the episodic subtype is more common, chronic tension-type headache significantly impacts health-related quality of life and contribute to increased healthcare utilization and disability. Despite considerable advances in the understanding of tension-type headache, critical gaps persist. This paper aims to provide a comprehensive review of the hallmarks of tension-type headache, from its pathophysiology, comorbidities, treatment options, to psychosocial impact.

Main results: Multiple factors are associated with tension-type headache, including peripheral mechanisms (increased muscle tenderness and myofascial trigger points), central sensitization, genetic predisposition, and psychological comorbidities such as anxiety and depression. Neuroimaging and neurophysiological studies demonstrated altered pain processing in cortical and subcortical regions in patients with tension-type headache. Regarding treatment strategy, in addition to pharmacological treatment, novel insights into non-pharmacological interventions such as cognitive behavioral therapy, neuromodulation techniques, physical therapy, mindfulness, lifestyle management, and patient education were highlighted as valuable components of comprehensive management strategies.

Conclusions: A complex interplay between peripheral and central mechanisms and psychosocial stressors underpins tension-type headache. Integrated multidisciplinary approaches combining pharmacological and non-pharmacological interventions are critical for optimal patient outcomes. Further research should continue to refine the understanding of these mechanisms to improve targeted therapeutic strategies and reduce the global burden of tension-type headache.

Keywords: Disease burden; Non-pharmacological treatments; Primary headache; Tension-type headache.

PubMed Disclaimer

Conflict of interest statement

Declarations. Ethics approval and consent to participate: Not applicable. Consent for publication: Not applicable. Competing interests: • Chen, Chu, Coppola, Della Pietra, Dong, Ekizoglu, Farham, Ha, Hsiao, Kissani, Labastida-Ramirez, Ling, Lytvyak, Onan, Yener, Papetti, Ozge, Tanprawate, Vongvaivanich, Y.G. Wang, Wijeratne declare no conflict of interests. • L. Al-Hassany is a member of the Methodology and Statistics Editorial Board of Neurology and a member of the Junior Editorial Board of The Journal of Headache and Pain. • C.C. Chiang has received consulting fee from Pfizer, Satsuma and eNeura. She receives research grant from the American Heart Association, with funds paid to her institution. • S.J. Cho is a member of the Editorial Board of The Journal of Headache and Pain, and Headache and Pain Research; site investigator of trials sponsored by Allergan, AbbVie, Hyundai Pharmaceutical, Ildong Pharmaceutical, Eli Lilly, Pfizer, and Lundbeck; receiver of honoraria for speaking or consulting from Abbvie Inc, GC Biopharma, Teva-Handok, GC Biopharma Corporation, and Onagon Korea. • C. Els is funded by the Canadian Centre of Recovery Excellence, reports grants from Workers’ Compensation Board of Alberta, and was employed by the College of Physicians & Surgeons of Alberta. • D. Garcia-Azorin has received honoraria as a moderator from AbbVie, Eli-Lilly, Teva, Organon, Lundbeck, and Pfizer. He has received consulting fees from Eli-Lilly, Organon, and Lundbeck, and has been the PI in trials sponsored by BioHaven, Lundbeck, and Pfizer. He has received research grants from Eli-Lilly, Carlos III Health Research Institute, and Regional Health Administration. D. Garcia-Azorin is associate editor of The Journal of Headache and Pain, visual abstract editor of Cephalalgia and junior editor of Neurological Sciences. D. Garcia-Azorin is a member of the Global Advisory Committee on Vaccine Safety of the World Health Organization. • R. Ishii has served as a consultant for Amgen K.K., Eli Lilly Japan K.K., Daiichi Sankyo Co., Ltd., Pfizer Japan Inc., and Otsuka Pharmaceutical Co., Ltd. He has received speaker honoraria from Amgen K.K., Daiichi Sankyo Co., Ltd., and Otsuka Pharmaceutical Co., Ltd. • B.K. Kim is on the Editorial Board of Journal of Clinical Neurology. He received honoraria as a moderator/speaker/advisor from Abbvie Korea, Teva-Handok, Lundbeck Korea, Pfizer Korea, Oganon Korea, Dong-A pharm, YuYu pharm, SK pharm, and Ildong pharm. • K.S. Lange reports a research grant from the International Headache Society; and personal fees from Teva; Organon. • L.L.H. Pan is a member of the Junior Editorial Board of The Journal of Headache and Pain. • L. Pellesi is member of the Editorial Board of The Journal of Headache and Pain, BMC Neurology and European Journal of Medical Research; Editor-in-Training for Clinical and Translational Science. • P. Martelletti serves as Editor-in-Chief of The Journal of Headache and Pain and SN Comprehensive Clinical Medicine and also serves as Expert EU Member at European Medicines Agency. • B. Raffaelli reports research grants from Lundbeck; Novartis; the German Research Foundation (DFG); and Else Kröner-Fresenius-Stiftung and personal fees from Abbvie/Allergan; Eli Lilly; Lundbeck; Novartis; Organon; Perfood; Teva. • A. Raggi is the Associate Editor of The Journal of Headache and Pain; Head of Public Health Section of SN Comprehensive Clinical Medicine. • S. Straube reports grants from the Workers’ Compensation Board of Alberta, the College of Physicians & Surgeons of Alberta, the Government of Alberta, and the Alberta Medical Association. Sebastian Straube also reports honoraria from the Occupational Medicine Specialists of Canada, the M.S.I. Foundation, the Canadian Centre of Recovery Excellence, and The Policy Works. • T. Takizawa is a consultant/advisor and/or serves on an advisory board for Eli Lilly, Otsuka, Amgen, Pfizer, and Teijin and has received speaker honoraria from Eli Lilly, Daiichi Sankyo, Otsuka, Amgen, Kowa, Kyowa Kirin, Eisai, UCB Japan, Takeda, Sawai, and Santen Pharmaceutical and grants from Eli Lilly, Pfizer and Tsumura outside the submitted work. • D. Uluduz has received honoraria as a moderator from AbbVie, Eli-Lilly; has received consulting fees from AbbVie, Eli-Lilly Turkey; and has been the PI in trials sponsored by Novartis. • M. Waliszewska-Prosół is on the Editorial Board of The Journal of Headache and Pain. • S.J. Wang has received honoraria as a moderator from AbbVie, Biogen, Eli-Lilly, Hava Biopharma, and Pfizer, has received consulting fees from AbbVie, Eli-Lilly Taiwan, Percept Co., and Pfizer Taiwan, and has been the PI in trials sponsored by Eli-Lilly, Lundbeck, and Novartis. He has received research grants from Taiwan branches of Eli Lilly, Novartis, and Orient Europharma. • J.W. Wu has received honoraria (as a speaker) from Biogen-Idec, Eli Lilly, Pflizer, AbbVie, and Organon & Co. He has received travel reimbursement and honoraria from American Academy of Neurology, International Headache Society, and Taiwan Headache Society. Also, he received research grants from the Taiwan Ministry of Science and Technology and Taipei Veterans General Hospital.

Figures

**Fig. 1**
The ICHD-3 criteria for tension-type headache and its subtypes. Tension-type headache includes episodic and chronic forms based on attack frequency. Episodic tension-type headache can be further divided into infrequent and frequent subtypes. TTH: tension-type headache

**Fig. 2**
Pathophysiology of tension-type headache. The pathophysiology of tension-type headache involves genetic, molecular, muscular, vascular, and central factors. Key factors include genetic polymorphisms, neuroinflammatory mediators, muscular abnormalities, altered central pain modulation, and changes in cerebral hemodynamics. Created in BioRender. Wang, S. (2025) https://BioRender.com/fs561jc. 5-HT: 5-hydroxytryptamine; CGRP: calcitonin gene-related peptide; NE: norepinephrine

**Fig. 3**
Common comorbidities of tension-type headache. Tension-type headache commonly co-occurs with musculoskeletal, gastrointestinal, and psychological disorders. Created in BioRender. Wang, S. (2025) https://BioRender.com/0lbeodj IBS: irritable bowel syndrome; TMJ: temporomandibular joint; TTH: tension-type headache

**Fig. 4**
Overview of tension-type headache management strategies. Tension-type headache management includes pharmacological treatments (acute and preventive) and non-pharmacological interventions such as neuromodulation, cognitive behavioral therapy, physical therapy, lifestyle modifications, and patient education. Created in BioRender. Wang, S. (2025) https://BioRender.com/yt61fvz. NSAIDs: non-steroidal anti-inflammatory drugs; PNS: peripheral nerve stimulation; tDCS: transcranial direct current stimulation; rTMS: repetitive transcranial magnetic stimulation

**Fig. 5**
Summary of lifestyle management strategies in tension-type headache. Key interventions include keeping headache diaries, alcohol and smoking management, and sleep regulation, each with varying evidence strength and clinical considerations. Created in BioRender. Wang, S. (2025)https://BioRender.com/ueqd7ss. CBT: cognitive behavioral therapy; RCT: randomized controlled trial; TTH: tension-type headache

See this image and copyright information in PMC

Comment on

Hallmarks of primary headache: part 1 - migraine.
Raggi A, Leonardi M, Arruda M, Caponnetto V, Castaldo M, Coppola G, Della Pietra A, Fan X, Garcia-Azorin D, Gazerani P, Grangeon L, Grazzi L, Hsiao FJ, Ihara K, Labastida-Ramirez A, Lange KS, Lisicki M, Marcassoli A, Montisano DA, Onan D, Onofri A, Pellesi L, Peres M, Petrušić I, Raffaelli B, Rubio-Beltran E, Straube A, Straube S, Takizawa T, Tana C, Tinelli M, Valeriani M, Vigneri S, Vuralli D, Waliszewska-Prosół M, Wang W, Wang Y, Wells-Gatnik W, Wijeratne T, Martelletti P. Raggi A, et al. J Headache Pain. 2024 Oct 31;25(1):189. doi: 10.1186/s10194-024-01889-x. J Headache Pain. 2024. PMID: 39482575 Free PMC article. Review.

References

1. Collaborators GDaI (2020) Global burden of 369 diseases and injuries in 204 countries and territories, 1990–2019: a systematic analysis for the global burden of disease study 2019. Lancet 396(10258):1204–1222 - PMC - PubMed
1. Stovner LJ, Hagen K, Linde M, Steiner TJ (2022) The global prevalence of headache: an update, with analysis of the influences of methodological factors on prevalence estimates. J Headache Pain 23(1):34 - PMC - PubMed
1. Headache Classification Committee of the International Headache Society (IHS) The International Classification of Headache Disorders, 3rd edition. Cephalalgia (2018);38(1):1-211 - PubMed
1. Holroyd KA, Stensland M, Lipchik GL, Hill KR, O’Donnell FS, Cordingley G (2000) Psychosocial correlates and impact of chronic tension-type headaches. Headache 40(1):3–16 - PMC - PubMed
1. Lyngberg AC, Rasmussen BK, Jorgensen T, Jensen R (2005) Secular changes in health care utilization and work absence for migraine and tension-type headache: a population based study. Eur J Epidemiol 20(12):1007–1014 - PubMed

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Hallmarks of primary headache: part 2- Tension-type headache

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Hallmarks of primary headache: part 2- Tension-type headache

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